PE for heart diseases Flashcards
common historical findings
Asymptomatic non-specific signs: lethargy, anorexia, weight loss, failure to thrive, withdrawn exercise intolerance respiratory distress coughing-at rest, during the night abdominal distension syncope sudden death
syncope
brief duration-sudden onset, quick recovery
flaccid or rigid
no muscle movement
pale or blue MM color
urination
may cry at onset
often triggered by activity or excitement
seizure
three phases: pre/ictal/post muscle movements throughout continual vocalizing urination defecation hyperthermia pink MM color
hands off examination
attitude, awareness, demeanor respiratory rate & effort coughing BCS cardiac cachexia abdominal distension
when cough is harsh and honking?
airway collapse
associated with excitement
when a cough is soft and quiet?
fluid in airways
where will you see cardiac cachexia most prominently?
spine and temporal region of head
What will the mucous membranes tell you?
capillary refill time (>2 seconds)=poor perfusion and peripheral vasoconstriction
hydration status
color
cyanosis
decreased oxygen bound to hemoglobin
caused by environment, pulmonary disease, right to left shunts
central cyanosis
intracardiac shunts
pulmonary disease
ex: tongue is blue
differential cyanosis
ex: MM of mouth=normal, MM of penis-cyanotic
reversed patent ductus arteriosus
normal jugular veins
non-distended
empty quickly following compression
pulsations less than 1/3 of neck
abnormal jugular veins
increased central venous pressure
pericardial effusion
caval obstruction
third degree AV block-cannon waves
tracheal palpation
how easy is it to elicit a cough?
auscultation approach
palpate for apex beat or thrill auscultate both sides of chest rhythm and rate analyssi listen to each valve area identify all sounds
apex beat
low frequency vibration on thoracic wall
contraction and rotation of heart
synchronous with early systole (S1 sound)
start place for auscultation-mitral valve location
strength not useful assessment
location of apex beat
normal: left side at 5th ICS, CC junction
abnormal-right side-right side enlargement, caudal=cranial mediastinal mass
where should you listen to a cat on auscultation?
sternal, right and left parasternal regions
most murmurs are heard at 4-5th ICS over or just to the right or left of the sternum
where should you listen to a dog on auscultation?
left axillary region-cranial dorsal to pulmonic valve region, murmur of PDA
right cranial region-2nd to 3rd ICS, murmurs often radiate to this region (aortic stenosis)
bradycardia in dogs
<60 bpm
tachycardia in dogs
> 160 bpm
bradycardia in cats
<100 bpm
tachycardia in cats
> 240 bpm
cyclical, associated with respiration heart rhythm
sinus arrhythmia
premature beat (heart rhythm)
often followed by a short pause (cats)
extrasystoles
sounds like tripping
pause or dropped beat (heart rhythm)
sinus arrest, second degree AV block
not associated with respiration
chaotic (heart rhythm)
atrial fibrillation
ventricular arrhythmias
paroxysmal (heart rhythm)
sudden onset and offset of arrhythmia